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Mediating effect of vascular calcification in galectin-3-related mortality in hemodialysis patients

Ji-Hwan Kim1, Hye-Mi Noh2, Hong Ji Song2

  • 1Department of Internal Medicine and Kidney Research Institute, Hallym University Sacred Heart Hospital, Pyungan-dong, Dongan-gu, Anyang, 431-070, Korea.

Scientific Reports
|January 10, 2024
PubMed

Insights

High galectin-3 levels predict mortality in hemodialysis patients, with vascular calcification and inflammation partially mediating this risk. This highlights galectin-3 as a potential biomarker for cardiovascular events in this population.

Area of Science:

  • Nephrology
  • Cardiology
  • Biomarkers

Background:

  • Galectin-3 is a potential biomarker for cardiovascular risk and mortality in hemodialysis (HD) patients.
  • A link between galectin-3 and vascular calcification (VC) has been recently identified.
  • The role of VC in mediating the association between galectin-3 and mortality requires further investigation.

Purpose of the Study:

  • To investigate the mediating role of vascular calcification (VC) in the association between galectin-3 and mortality among incident hemodialysis (HD) patients.
  • To analyze the direct and indirect effects of galectin-3 on mortality, considering VC and inflammatory markers.

Main Methods:

  • Serum galectin-3 and baseline aortic arch calcification (AoAC) scores were measured in 477 incident HD patients.
  • Mortality data were collected over a median follow-up of 40 months.
  • Causal mediation analysis was employed to assess the impact of vascular risk factors on galectin-3-related mortality.

Main Results:

  • Aortic arch calcification (AoAC) was prevalent in 57% of HD patients.
  • Elevated galectin-3 levels were significantly associated with an increased risk of AoAC.
  • Higher galectin-3 levels (median 37 ng/mL) increased all-cause mortality risk by 1.71-fold, even after adjusting for cardiovascular risk factors.
  • Mediation analysis revealed significant direct effects of galectin-3 on mortality and significant indirect effects mediated by AoAC score and high-sensitivity C-reactive protein (hs-CRP) levels.

Conclusions:

  • The association between elevated galectin-3 and mortality in hemodialysis patients may be partially explained by increased vascular calcification (VC) and inflammation.
  • Galectin-3, VC, and hs-CRP are significant factors contributing to mortality risk in the HD population.
  • These findings suggest galectin-3's potential as a biomarker for cardiovascular outcomes in HD patients, with VC and inflammation playing key mediating roles.

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